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Survival in Type 1 and Type 2 Diabetes in a Population Referred for Invasive Evaluation of Coronary Disease

Per Mølstad1, Olaf Rødevand

  • 1Department of Cardiology, Feiring LHL Clinics, Feiring, Norway.

Cardiology
|December 11, 2017
PubMed

Insights

Patients with type 1 and type 2 diabetes face higher long-term mortality. While mortality has decreased for type 2 diabetes patients, those with type 1 diabetes have not seen similar survival improvements.

Area of Science:

  • Cardiology
  • Endocrinology
  • Public Health

Background:

  • Diabetes mellitus, encompassing type 1 and type 2, is a significant comorbidity in patients undergoing treatment for coronary artery disease.
  • Understanding long-term survival trends in diabetic populations with coronary disease is crucial for effective healthcare management and resource allocation.

Purpose of the Study:

  • To compare long-term survival rates between patients with type 1 diabetes, type 2 diabetes, and those without diabetes undergoing invasive coronary treatment.
  • To analyze temporal trends in mortality for these patient groups over time.

Main Methods:

  • A cohort study of 43,872 patients referred for invasive coronary treatment between March 1999 and December 2014.
  • Survival status was tracked until September 20, 2015, with subgroup analysis for patients with type 1 diabetes (n=1,326) and type 2 diabetes (n=4,564).
  • Cox regression analysis was employed to assess hazard ratios (HR) for mortality, comparing different diabetic statuses and treatment periods (pre- and post-2007).

Main Results:

  • Both type 1 and type 2 diabetes were associated with significantly increased long-term mortality (HR 1.78 and 1.29, respectively).
  • A significant reduction in mortality was observed in patients without diabetes (HR 0.78) and with type 2 diabetes (HR 0.76) in the period after 2007.
  • No significant reduction in mortality was found for patients with type 1 diabetes in the recent treatment period (HR 1.03).

Conclusions:

  • Type 1 and type 2 diabetes are linked to excess long-term mortality in patients with coronary artery disease.
  • Recent improvements in survival observed in non-diabetic and type 2 diabetic patients were not mirrored in the type 1 diabetic cohort.
  • These findings highlight a persistent survival gap for type 1 diabetes patients requiring invasive coronary treatment.
Abstract

Keywords:
Coronary heart diseaseCox regressionMortalityType 1 diabetesType 2 diabetes

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